Advance care planning - choosing the right path

Paul Hensby of Final Choices highlights steps you should consider to give you more control over the care options when facing an end of life illness.

Advance Care Planning (ACP) is a voluntary discussion process that takes place between a terminally or chronically ill patient and their care providers and relevant health care professionals.

You can opt to do this on your own or you can involve your family and friends in this process. The benefit of the plan is that it enables your care team to record your wishes so the key people are aware of them, and also review and amend it when appropriate.

What should an ACP discussion include?

You should include any concerns you have about your care, your understanding about your illness or prognosis, and your preferences for different types of care and treatment.

During the discussion, your health care professional will advise you on the options and services that are available to you.

These discussions are entirely 'patient-centred', and are conducted over a period of time and at a pace that is appropriate for you. Advanced Care Planning gives you the opportunity to discuss your end-of-life care with your family and friends as well as health care professionals.

An ACP discussion gives you the maximum choice and control over the end of your life.

What you can achieve through ACP:

ask your care team any questions you have;

understand the options that may be available to you;

gain advice on various types of care and treatment;

ensure that the relevant members of your family and care team are aware of what you will want and need at the end of your life.

When to request Advance Care Planning

If possible have an ACP discussion in advance of an anticipated deterioration of their health, for example, on reaching the final stages of a terminal illness, or when your health is deteriorating due to old age.

The earlier you start to think about your advanced care, the more likely you are to be fully aware of the choices open to you, and to ensure your loved ones and carers know of your plans.

How to request an ACP discussion

Ask one of your care team or your GP and they will arrange for an appropriate professional, someone who knows your health record, to conduct your ACP discussion.

Preferred Priorities for Care (formerly Preferred Place of Care) form

The Preferred Priorities for Care (PPC) form is designed to help you think about and discuss your preferences and priorities for care at the end of your life.

The PPC form enable you, your family and any health care professionals involved in your care to understand what you want when planning your care.

PPC forms are also useful if you later lose the capacity to make decisions for yourself; anyone involved in your care has to take account of what you have written in your PPC form.

However, the PPC form is not a legally binding document and preferences such as the refusal of treatment would need to be recorded in an Advance Decision in order for them to have statutory force.

Death plan

Final Choices has produced a Death Plan template to encourage terminally ill patients and those approaching the end of their lives to talk to their families and health professionals, and if appropriate, ministers of religion, about how and where they want to die.

The plan includes where the person wants to die, who should be there, the level of medical intervention, what the person wants to hear, smell and see and who should be told of the imminent passing.

About the author

Paul Hensby is the editor of Final Choices, the information and community platform for people facing or living with end of life issues. Paul trained as a copywriter and journalist at the Reader’s Digest before working for a number of publications, including The Director Magazine, the monthly publication of the IoD which he edited for two years.